| NPI | 1124482229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA ROMOS Director 414-372-3903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WI 5) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2022-07-21 |